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NPI Code Detail

MEDICARE: TRADEWIND MANAGEMENT LLC

MEDICARE: TRADEWIND MANAGEMENT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1457978306
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRADEWIND MANAGEMENT LLC
Provider Business Mailing Address
First Line : PO BOX 251504
Second Line :
City : PLANO
State : TX
Zip : 75025-1504
Country : US
Telephone Number : 214-390-7697
Fax Number : 888-770-6360
Provider Business Practice Location Address
First Line : 4090 MAPLESHADE LN STE 100
Second Line :
City : PLANO
State : TX
Zip : 75093-0025
Country : US
Telephone Number : 214-390-7697
Fax Number : 888-770-6360
Authorized Official
Title or Position : ADMIN
Name : VUDHI V SLABISAK
Credential :
Telephone Number : 214-390-7697
Provider Enumeration Date : 06/26/2020
Last Update Date : 06/26/2020

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Directions to “TRADEWIND MANAGEMENT LLC ” Practice Location

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